Recently I consulted with therapists and social workers at a mental health agency to offer ways they can better support clients who hoard. The interesting thing was that several staff shared examples of their own family members who hoard. Researchers estimate that around 6% of the U.S. population struggle with hoarding, but it sure seems higher to me.

Your grandmother may have lots of things in her home, but how do you know if it's actually hoarding? How can you best support her? What's the long term outlook?

Signs that someone is hoarding:

Excessively acquiring items that are not needed or for which there's no space. An extra coffee maker for which is no room on the counter or another vacuum cleaner even though there is little open floor space.

Persistent difficulty throwing out or parting with things, regardless of actual value. Perhaps years of junk mail or empty boxes.

Feeling a need to save these items, and being upset by the thought of discarding them. She may feel anxious at the idea of throwing out expired food.

Building up of clutter to the point where rooms become unusable. Her stovetop is covered in groceries that won't fit in the cupboards or bathtub full of clothes.

Having a tendency toward indecisiveness, perfectionism, avoidance, procrastination, and problems with planning and organizing. "I might need this someday."

Why do people hoard?

Primary causes seem to be genetics (there is a specific gene correlated with hoarding behaviors) or very stressful events such as a house fire, or extreme poverty as a child.

How can you help?

Help your grandmother create an interesting and engaging life...don't just focus on the problem.

Gain her trust by listening to understand, and refrain from sharing your personal judgments. Shame and criticism are not helpful.

Don't expect her to make logical decisions about what to keep and what to give away.

Start with most helpful area, such as the stovetop, or bathtub or bed.

Work in small chunks and celebrate small wins and negotiate limits.

How likely is it that someone totally stop hoarding?

Not great, the research I’ve read reports less than 50% have significant improvement; hoarding is actually more of a management situation.

It’s most helpful if they can get coaching or therapy early and stick with it.